Methodist Hospital Infrastructure Upgrade

A History Together

The infrastructure upgrade project represents a series of design and construction work that began with a facility assessment under a master plan initiated in 1998.

A healthcare facility’s success is in-part measured by its ability to adapt and respond to the always changing healthcare marketplace. For Methodist Hospital, what began as a facility assessment in 1998 soon grew into a complete infrastructure upgrade. GS&P successfully employed mechanical, electrical, plumbing, fire protection, structural, and civil engineering disciplines in a way that did not interrupt the hospital’s service, and in a format that assured the hospital will be capable of responding to constantly evolving demands. Unique in its duration, broad scope, and flexibility of implementation, the project represents GS&P’s broad range of multidisciplinary capabilities, knowledge of modern healthcare delivery, and commitment to a long-term client.

How did the Methodist infrastructure project begin?

Dave McMullin: The original master plan began in 1998 as an evaluation of the facility to identify deficiencies in the infrastructure. The owner basically told us to list what needed to be done, rank them in order of priority, and estimate the costs for everything.

What did you identify as the first priority?

Dave: From the evaluation, we created a matrix of things that needed to get done, so that it was more of a master plan for a facility upgrade as opposed to just picking the top three projects and doing them.

Is it fair to say that you had to prioritize as you went along when other needs and issues became apparent?

Dave: Yes. A good example is when we were planning the growth of what became the south tower. We identified a need for normal and emergency power, so we developed a separate project called “the powerhouse project”, which was basically a relocation of electrical services on the site. As part of that, we noted that the oxygen part of the medical gas system was in a bad location and difficult to service. We worked with the owner to determine how to relocate the oxygen on the site in conjunction with the powerhouse project, which took it out of the scope of the infrastructure project and made it something else. So by identifying the issue and letting the owner perform the majority of the work with his staff, we saved him money and time, and we ended up with the result we were looking for.

How did the original master plan look in its first stages?

Dave: During the development of the master plan, we identified deficiencies in the infrastructure. Some of the issues became less important, but the important issues needed to be handled in order for the hospital to continue operating, or so another project could occur. Those were pulled out separately, and often could be done as part of other projects. Those that could not be a part of other projects became part of the infrastructure project, which was basically a series of tasks that were either accomplished by the owner and a contractor if necessary.

Can you give an example of a project that changed in the course of working on another phase of the master plan?

Dave: We identified a deficiency in the fire sprinkler system that prevented it from being able to provide sufficient service from the fire pump to all the standpipes. As we worked through it, we discovered that, given a little general direction from us, a certified fire protection contractor could actually do the work because he could get the permitting and documentation without having us design documents, which saved the owner a fair amount of time and money. In the end, not only did we solve a problem identified in the master plan, which was a deficient fire pump, we also provided a single source of fire protection service for the entire campus without having to execute a significant design document.

What are some other examples of challenges that required innovative solutions?

Dave: In conjunction with the oxygen part, we rearranged the other medical gas systems which included vacuum, medical air, nitrogen and nitrous oxide, and basically relocated the manifolds and the main services from co-deficient locations to a new spot within the facility. By doing that, we created their first accurate record drawing of the piping system in the building. We also identified connection locations that they could do with minimal downtime allowing them to flip those services without a significant disruption to the hospital. They were able to do this primarily because the hospital had certified technicians on staff that could make those changes when it was convenient for the hospital. So again, by taking advantage of the resources at hand and working with them instead of with a contractor, they were able to do things quicker and more cost efficiently.

Did the hospital incorporate cosmetic changes as the infrastructure was redesigned?

Dave: Yes, as we moved along, we determined that the hospital’s growth was going to cause an increase in demand for heating and cooling. While that wasn’t much of a concern in 1998, as we moved into 2005 the age of the equipment, particularly the boilers, became a factor. The boilers were originally installed in the ’60s and were approaching the end of their useful lives. They were also in a location that had become difficult to manage, as the hospital had grown around that part of the powerhouse. As we developed new schemes of the master plan, we discovered an opportunity to relocate the boiler house to a location that was outside of the actual existing building envelope.

Why was it necessary to move the boilers?

Dave: Boilers are particularly difficult to deal with inside a hospital because they require a lot of service, and the flues from the boilers are not easy to deal with. So we located a new boiler plant on what was to become the service (back) side of the building, yet still in a prominent location. Appearances were important, so we located it between the new electrical powerhouse and the existing facility, which made good use of the existing land and took advantage of a spot we weren’t going to be able to leverage for any other clinical use. The really interesting thing about the powerhouse is that we phased out the existing steam boilers and leveraged that space as the location for the new chilled water expansion. Similarly, the space that was vacated when we built the electrical powerhouse was reused for piping and distribution systems to the newly planned south tower of the hospital.

Is it correct to say that as the master plan was updated, so was the infrastructure plan?

Dave: Although they were separate projects, they weren’t done independently. We always tracked them together so that when we re-valuated the master plan, we would also reevaluate the needs of the infrastructure.

What regard was given to sustainability?

Dave: The first way to be sustainable is not to use something, so in that sense, repurposing an existing building is a sustainable solution, which means that we were sustainable from the start: We reused the building envelope for another purpose. In addition to that, the new boiler plant utilizes some fairly sophisticated energy conservation measures including boiler stack economizers to recover heat normally thrown away to preheat water going into the boiler system. We also utilized high-efficiency boilers and installed low-emission boilers that are friendlier to the environment.

Are the chillers more efficient as well?

Dave: The chillers are significantly more efficient, but we actually only replaced one chiller by taking out an old chiller and putting in a new one with a slightly higher capacity. Because of the way we revised the piping system, we were actually able to get capacity out of the system that was locked in there with no way to distribute. We created a new distribution system to reuse the existing capacity in a more efficient manner. We also allowed for those existing chillers to be replaced, in time, with new chillers that will be of higher efficiency, and we’ve got a spot built into the plan for the next chiller so we don’t have to take anything out. We actually have it piped up and ready to go when the next expansion project comes along.

Where does the project stand right now?

Dave: The hospital infrastructure project, as we know it, is as complete as it needs to be for the time being. The infrastructure issues that we identified have primarily been resolved, with only a couple still outstanding. But they’re of much lower importance now that the owner has completed the south tower construction, which rebuilt and relocated the surgery center and women’s services as part of the master plan.

Where do you think they would be if they hadn’t been so proactive about looking into the future and addressing the master planning and infrastructure needs?

Dave: The worst case scenario is that they could have been acquired by someone else. They wouldn’t have had the ability to accomplish the expansions that they’ve been able to do. From an economic standpoint, some of the things we’ve done have allowed them to stay on the forefront of their market.

What aspects of this project are the most gratifying to you?

Dave: I’m especially proud of the chilled water system because the first thing they said when we met them in 1998 is, “Our chilled water system doesn’t work.” When I talked to Roger Lathom, the facility’s operator, a couple of months after we finished the chilled water system interconnection, which was the last piece of the puzzle, he said he didn’t have any problems, which is about as much of a compliment we can ask for.

What do you most attribute to this project’s success?

Dave: For a project like this to be successful, you have to bring all the necessary disciplines together without having to stop and figure out what to do. We have the people on staff and the institutional knowledge in the firm with structural, mechanical, electrical, and civil engineers, as well as plumbing and fire protection engineers, architects, and interior designers who all worked together. They knew this facility and this group, so that when plans changed, they knew what to expect as opposed to having to wait and see what happens. We were able to see the impact of our work as it was happening, as opposed to being reactive.

But ultimately it all points back to our long-term relationship with the client. I can’t say enough about how beneficial it has been to know their history and goals. We are able to give our best recommendations because we truly know them, and, as we look ahead to our future projects, I expect that success to continue.

Gresham, Smith and Partners is a privately held firm of architects, engineers, interior designers and planners creating design and consulting solutions for the built environment. Our more than 800 employees are committed to building value with our clients as trusted advisors and to making positive social, economic and environmental impacts in our communities. In 2017, GS&P proudly celebrates 50 years in business. We look forward to continuing to serve our clients while fostering the professional and personal growth of our employees.